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TRANSCRIPT
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AD-Ai63 998 AEROBIC CAPACITY AND CORONARY RISK FACTORS IN A 1/1MIDDLE-AGED ARMY POPULRTION(U) RRMV RESEARCH INST OFENVIRONMENTAL MEDICINE NATICK MA J F PATTON ET AL
UNCLASSIFIED JAN 86 USRIEM-M-8/86 F/G 6/14 UL
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SECURITY CLASSIFICATION OF THIS PAGE (Wen Data Entered) ,.,,
REPORT DOCUMENTATION PAGE READ InSTRUCTIONSBEFORE COMPLETMG FORM
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4. TITLE (and Subtitle) S. TYPE OF REPORT & PERIOD COVERED
Aerobic Capacity and Coronary Risk Factors
in a Middle-Aged Army PopulationS. PERFORMING ONG. REPORT NUMBER
AUTHOR(@) 0. CONTRACT OR GRANT NUMBER(e)
w John F. Patton, Ph.D., James A. Vogel, Ph.D.,O' COL Julius L. Bedynek, Jr., M.D. ,Ph.D., MC,
MAJ Donald Alexander, M.D.,MC, MAJ Ronald Albrigh ,
PERFORMING ORGANIZATION NAME AND ADDRESS DI.UJ. ),M. 10. PROGRAM ELEMENT. PROJECT, TASKAREA A WORK UNIT NUMBERS
(V) "US Army Research Institute of EnvironmentalMedicine, Natick, MA 01760
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II. SUPPLEMENTARY NOTES
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7-9IS. KEY WORDS (Continue on reveree side If neceeary and identify by block number)
Aerobic capacity, coronary risk factors, treadmill testing, peak oxygenuptake.
..20. ABSTRACT (mort.muo am reverse, N ne ey ma d identifi by block niumber)
TLLI he purpose of this study was to assess the relationship between coronary riskn,J factors (CRF) and aerobic capacity measured by the direct determination of
&.. oxygen uptake during maximal exercise testing. Subjects comprised 295 maleArmy personnel (40-53 yrs of age) who underwent multiple serial screening pro-
-,. cedures to include a medical and physical evaluation, calculation of a Framing-IMF" ham risk factor index (RI) and a graded treadmill exercise test (GXT) with the
determination of peak oxygen uptake (pV02). CRF included resting systolic (SBP)and diastolic (DBP) blood pressures, total cholesterol (TC), HDL-C, triglycer-.
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SIECURITY CLASSIFICATION OF THIS PAGZ(lh, Data 3Am60
ides (TRIG), fasting blood sugar (FBS), smoking history, resting ECG, and per-cent body fat (% BF), The mean + SD for pVO2 and % BF was 38.1 - 6.2 ml/kg.minand 26.1 + 4.7%. An inverse relationship was found between CRF and level ofaerobic capacity. SBP, DBP, FBS, and TRIG were significantly lower and HDL-Csignificantly higher in the most aerobically fit subjects (pVO 2 >45.0 ml/kg.min)compared to thse in the least fit group (pVO2 '30 ml/kg.min). Thus, the morefit group had~a lower RI(p .01) than the less fit subjects (2.5 + 0.2% vs.4.7 + 0.4%). TheW results, although cross-sectional, imply that a high levelof aerobic capacity is associated with lower coronary risk factors.
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Aerobic Capacity and Coronary
Risk Factors in a Middle-Aged
Army Population
by
John F. Patton, Ph.D., James A. Vogel, Ph.D.,
COL Julius L. Bedynek, Jr., M.D., Ph.D., MC,
MAJ Donald Alexander, M.D., MC, MAJ Ronald Albright, M.D., MC
US Army Researnh Institute of Environmental Medicine, Natick, MA.,
Office of the Surgeon General, Pentagon, Washington, DC.
Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA.
Martin Army Community Hospital, Fort Benning, GA.
Send Correspondence to:
Dr. John F. Patton
US Army Research Institute of
Environmental Medicine
Natick, MA 01760-5007
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HUMAN RESEARCH
Human subjects participated in these studies after giving their free andInformed voluntary consent. Investigators adhered to AR 70-25 and USAMLRDCRegulation 70-25 on Use of Volunteers in Research.
The views, opinions, and/or findings contained in this report are those ofthe author(s) and should not be construed as an official D~epartment of theArmy position, policy, or decision, unless so designated by other officialdocumentation..
Acces ion
ForNTIS CRAMIUTIC TABUnannounced 0Justificatioll
...................... ..................By
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Aerobic Capacity and Coronary Risk Factors
ABSTRACT
The purpose of this study was to assess the relationship between coronary
risk factors (CRF) and aerobic capacity measured by the direct determination
of oxygen uptake during maximal exercise testing. Subjects comprised 295
male Army personnel (40-53 yrs of age) who underwent multiple serial
screening procedures to include a medical and physical evaluation,
calculation of a Framingham risk factor index (RI) and a graded treadmill
exercise test (GXT) with the determination of peak oxygen uptake (pV02 ). CRF
included resting systolic (SBP) and diastolic (DBP) blood pressures, total
cholesterol (TC), HDL-C, triglycerides (TRIG), fasting blood sugar (FBS),
.smoking history, resting ECG, and percent body fat (% BF). The mean + SD for
pv' and % BF was 38.1 + 6.2 ml/kg-min and 26.1 + 4.7%. An inverse
relationship was found between CRF and level of aerobic capacity. SBP, DBP,
FBS, and TRIG were significantly lower and HDL-C significantly higher in the
most aerobically fit subjects (pVO 2>45.0 ml/kg-min) compared to those in the
least fit group (pVO2
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Aerobic Capacity and Coronary Risk Factors 2
Introduction
The age-adjusted cardiovascular mortality rate h4as fallen considerably in
the United States over the past 20-30 years. One of the primary reasons for
this decline has been the identification and modification of factors which
place an individual at an increase:d ..isk for the development of coronary
heart disease. Such modifications have included dietary changes, cessation
of smoking, hypertension control, and increased physical activity. The role
of physical activity in the development of premature coronary heart disease
and in modifying coronary risk factors has been the subject of considerable
- research over the past few years.2-3
The determination of maximal oxygen uptake provides the most objective
index of an individual's physical fitness or aerobic capacity. 4 -5 To avoid
the disadvantages of directly measuring oxygen uptake (equipment cost,
personnel time, etc) attempts have been made to predict this variable; the
most widely used method is to estimate it from maximal exercise time.6
Studies have shown, however, that maximal oxygen uptake can only be grossly
estimated from maximal treadmill time using either the Bruce or Balke
7protocols.
In cross-sectional studies reporting on the relationship between physical
fitness and coronary risk factors, treadmill time8 -9 and submaximal heart
rate10 have been used to predict aerobic capacity and to categorize
Individuals Into various cardiorespiratory fitness levels. The present
study provides further cross-sectional data on the relationship between
aerobic capacity and coronary risk factors where a direct determination of
oxygen uptake and, therefore, an objective measure of aerobic capacity was
used during maximal treadmill testing.
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Aerobic Capacity and Coronary Risk Factors 3
Methods
Subjects participating in this study were 295 male personnel aged 40 and
over (age range 40-53) who were randomly selected from approximately 600
individuals assigned to a US Army post. Subjects volunteered to participate
and informed consent was obtained. The sample consisted of 173 enlisted and
122 officer personnel who represented a typical cross-section of job
assignments, i.e. medical, administrative, tactical, unit commanders, etc.
common to any large Army installation.
The data on all subjects were collected within a three week period.
0O During the first week each subject completed a cardiovascular history and
underwent a physical examination. Any of the following conditions found
during either the history or the exam resulted in a positive or abnormal
rating: angina pectoris or suspicious chest discomfort, dyspnea at rest,
syncope, precordial palpitation, prior diagnosis of hypertension or treatment
of hypertension, history of myocardial infarction, significant cardiovascular
finding (e.g. pathologic murmur or heart sound, cardiomegaly, etc) and any
other clinical cardiovascular finding which was significant in the judgment
of the examiner.
The following coronary risk factors as identified in the Framingham Heart
Study were assessed: age, blood pressure, smoking history, carbohydrate
tolerance, resting ECG and total serum cholesterol.' These factors were then
used to calculate a risk factor index for each subject as described by Kannel
4et a12. A standard 12-lead scalar resting ECG was obtained using disposable
skin electrodes. Blood pressure was taken in a quiet place with the subject
relaxed and sitting comfortably. Subjects were grouped as smokers (> 10
lie
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Aerobic Capacity and Coronary Risk Factors 4
cigarettes/day) or nonsmokers. No attempt was made to record the length of
time since the start of smoking or whether nonsmokers had ever smoked. A 10
ml blood sample was taken from the antecubital vein at least 12 hours after
the last meal. Total cholesterol (TC) and fasting blood sugar (FBS)'as well
as triglycerides (TRIG) and HDL-cholesterol (HDL-C) were analyzed by standard
automated laboratory procedures.
During the next two weeks, all subjects underwent a physician-supervised,
multistage, symptom-limited exercise tolerance test using the US Air Force
School of Aerospace Medicine (USAFSAM) treadmill protocol. 13 This is a
modified Balke procedure where the treadmill is set at a fixed speed of 90
m/min (3.3 mph) at 0% grade. With the speed kept constant, the grade is
raised 5% every 3 min without interruption until the subject is unable to
continue due to exhaustion or until symptoms occur. The American Heart
Association standards14 were followed during performance of the test. To
determine aerobic capacity, oxygen uptake was measured at each level of
exercise and the highest value achieved at the time of exhaustion was taken
as peak oxygen uptake (prO2 ). This term is used to distinguish it from
maximal oxygen uptake which implies a plateauing in VO2 with increased
exercise intensity. In agreement with Taylor et a115 , we found that
plateauing of V 2 seldom occurs with continuous treadmill protocols.
During the third minute at each stage of exercise, expired gas samples
were collected through a mouthpiece attached to a Koegel low-resistance
breathing valve into Douglas bags. An aliquot of expired air was analyzed
for 02 and CO2 by means of an Applied Electrochemistry S-3A analyzer and a
Beckman LB-2 analyzer, respectively. Expired air volumes were measured with
a Collins chain-compensated tissot gasometer. The following parameters were
-- J
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Aerobic Capacity and Coronary Risk Factors 5
derived from the gas exchange data: minute ventilation (E), oxygen uptake
(002 ) and the respiratory exchange ratio (RER).
Body weight (kg) and height (cm) were measured and skinfold thickness
(mm) determined at the subscapular, triceps, biceps, and suprailiac rtes
using Harpenden calipers. Age-adjusted regression equations were used to
estimate percent body fat.16
Of the 295 subjects initially evaluated, 25 had an abnormal graded
exercise test while an additional 9 did not achieve a sufficient exercise
intensity to elicit a pVO 2 . These individuals, therefore, were not included
in the data analysis. Subjects were grouped based on their pVO2 into five
levels of aerobic capacity: < 30; 30-34, 35-39; 40-44; and > 45 ml/kg-min.
A one-way analysis of variance (ANOVA) was used to determine significant
differences among levels of aerobic capacity and the risk factors. The
multicomparison test, Tukey's highly significant difference (HSD), was
employed to establish statistical significance of mean differences. The mean
square of the ANOVA was corrected for the differences in sample size among
levels of pVO 2 in order to calculate the t-statistic using Tukey's HSD.
Results
The descriptive data for age, anthropometric measures, peak
physiological responses to exercise and coronary risk factors are presented
in Table 1. The mean pVO 2 was 38.1 + 6.2 ml/kg-min (range 25.3 to 61.1
ml/kg.min).
The prevalence of coronary risk factors is presented in Table 2. The
data show 64% of the individuals with body fat contents greater than 25%, 24%
had blood pressures greater than 140/90 mmHg, 61.8% had blood cholesterol
levels above 200 mg/dl, and 50% of the sample had a positive smoking history.
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Aerobic Capacity and Coronary Risk Factors 6
These data resulted in 18% of the subjects acheiving a Framingham risk
factor index equal to or greater than 5%. Abnormal graded exercise tests
were found in 8.8% of the sample. These were divided into three categories
as follows: > 1.0 < 2.0 mm ST segment depression (72%); > 2.0 mm ST'segment
depression (16%); ventricular ectopy (12%).
The data comparing anthropometric, physiological, and risk factor
variables among the five ranges in pVO 2 are shown in Tables 3 and 4.
Significant differences in respect to only the highest pVO 2 range (> 45
ml/kg-min) are indicated in both tables. There were no differences in age
across the pVO2 levels (Table 3). Body weight and % body fat were inversely
related to the level of aerobic capacity. No differences were found in peak
HR or peak RER among groups suggesting that subjects in each of the pbO2
ranges achieved similar levels of exertion during the exercise test. A
significant positive relationship was found between pVE and pVO 2 range; 104
1/min in the lowest pO group compared to 140 1/min in the highest
group. Treadmill time was also significantly greater with each higher level
of pVO2.
In Table 4 a direct inverse relationship was seen among levels of aerobic
4 capacity and each of the CRF. However, the relationship did not reach levels
of significance for all factors. Over 70% of the subjects in the lower pVO2
groups had a positive smoking history whereas only 20-30% of those in the
higher aerobic ranges were smokers (p
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Aerobic Capacity and Coronary Risk Factors 7
resulted in a TC/HDL-C ratio of 6.1 for the lowest pVO 2 group compared to a
ratio of 4.6 for the highest pVO2 group (P 45 ml/kg.min group and showed a progressive
V lowering across groups. Fasting blood sugar was significantly higher (p
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Aerobic Capacity and Coronary Risk Factors 8
Discussion
The principal finding of this study was the significant inverse
relationship seen among levels of aerobic fitness and many of the factors
related to the development of CAD in an asymptomatic, middle-aged population.
* While these results confirm the findings of earlier cross-sectional8-10
studies, they differ in one important respect: the direct measurement of
oxygen uptake during maximal exercise was used to objectively determine
aerobic capacity rather than indirect estimates such as treadmill time or
submaximal heart rate.
The measurement of oxygen uptake during maximal exercise is considered
0 5the best index of aerobic capacity. Because of the technical difficulties,
most laboratories do not directly determine this variable during graded
exercise testing. The most common method for estimating oxygen uptake has
been to use linear regression equations relating treadmill performance to
6,oxygen uptake. These predictive equations, however, tend to be population
specific and valid only through a limited range. Furthermore, oxygen uptake
can vary widely among individuals for any given treadmill time in either the
Bruce or Balke protocols.7
The aerobic capacity reported herein agrees favorably with values from
172civilian studies on the age 40 and over individual. 1 7 2 0 While valid
comparisons are difficult due to differences in testing methods and in the
physical activity history of the subjects, these studies have generally found
'the maximal oxygen uptake to range between 30 and 40 ml/kg.min. Only a few
studies on military populations are .available for comparison. Froelicher et
al21 found an average maximal oxygen uptake of 34.0 ml/kg.min for USAF
aircrewmen of comparable age. In a large survey of Canadian Forces personnel%',,!
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Aerobic Capacity and Coronary Risk Factors 9
between the ages of 40-55 years, Myles and Allen2 2 reported a predicted
maximal value of 32.4 ml/kg-min which, when corrected upwards by 15% to
account for differences between the cycle ergometer and treadmill, 2 3 is
similar to that reported herein.
The mean values for the various CRF also fell within the range of values
reported for other comparably aged, asymptomatic male subjects.3 '8 '2 4 The
most prevalent risk factors found in this study were obesity, elevated blood
cholesterol, hypertension and positive smoking history. Obesity has been
identified as one of the most prevalent health problems at all ages in the
United States and has recently been shown to be an independent risk factor
for CAD.2 5 The 63.8% prevalence of body fat content in excess of 25% (17.4%
In excess of 30%) found in this group would appear to be rather high.
However, similarly high levels of body fat have been reported for other 40
and over age groups.8 ,10
The high incidence of smokers (50%) is similar to that reported for
other military populations, 10,26,27 and represents the most predominant risk
factor in this group. The demonstrated inverse relationship between aerobic
fitness and percent smokers is also in agreement with previous cross-
sectonal3,10sectional reports and with studies on the effects of smoking on maximal
oxygen uptake.28 ,29 Cigarette smoking is known to interfere at a number of
points in the 02 delivery system, most notably by increasing the levels of
carboxyhemoglobin 30 and through a negative effect on pulmonary function.3 1
Indeed, the significantly lgwer maximal ventilation in the less aerobically
fit groups suggests an effect of smoking on airway conductance.
While the relationship between total cholesterol levels and aerobic
fitness did not reach statistical significance, the magnitude of the
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Aerobic Capacity and Coronary Risk Factors 10
differences between the least and most aerobically fit groups was similar to
that reported in other cross-sectional studies. 8,10 Furthermore, the
differences in HDL-C values among groups were also in agreement with other
cross-sectional data relating higher levels of HDL-C to higher levels of
physical activity in men. 32,33 Such findings resulted in higher TC/HDL-C
ratios in the lowest pbo2 groups compared to the highest. Gibbons et a19
found this ratio to have the strongest association with fitness as measured
by treadmill time among all the risk factors studied in a large sample of
women. Furthermore, Wilson et a13%elieve this ratio to be the best
predictor of CAD risk among all of the blood lipid indexes while Uhl et al 35
have suggested that a TC/HDL-C ratio >6 is a significant additional risk
factor.
The effects of exercise on blood pressure are dependent upon many
interrelated factors such as the dietary habits and body composition of the
subjects under investigation. Furthermore, showing a significant relationship
between blood pressure and aerobic fitness has been more difficult in
normotensive then hypertensive subjects. Thus changes in blood pressure
which have been documented due to exercise have been modest in moststudes.3
studies. 38 In the present study small differences were seen across
fitness groups for both systolic and diastolic blood pressures but levels ofsignificance were reached only when the two extreme pVO2
p 2 groups were
compared. Similar results have also been reported in other cross-sectional
studies with the magnitude .of changes (10 and 9 mm Hg for systolic and
diastolic pressures, respectively) being nearly identical to those reported
by Cooper at al8 and Brown et al 0 for comparably aged subjects.
.OZ
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A Aerobic Capacity and Coronary Risk Factors 11
In conclusion, the data from this study show that a significant inverse
relationship exists among levels of aerobic capacity as measured by the
direct determination of oxygen uptake and many of the factors purported to
place an individual at increased risk for the development of CAD. Since, the
data are cross-sectional in nature, a cause and effect relationship can not
be e:ta!.:ished. However, the findings support the implied risk factor
8-10improvement suggested by other cross-sectional studies and a recent
longitudinal study 3 all of which utilized indirect measures to assess
aerobic fitness.
4.
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Aerobic Capacity and Coronary Risk Factors 12
ACKNOWLEDGEMENTS
The authors wish to express their sincere appreciation to Mrs. EmilyHamilton and Mrs. Dora Ward for the excellent preparation of the manuscript.
,c. -
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p..
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Aerobic Capacity and Coronary Risk Factors 13
REFERENCES
1. Levy RI: Causes of the decrease in cardiovascular mortality: Am. J.Cardiol. 1984; 54:7C-13C.
2. Kannel WB, Wilson P, Blair SN: Epidemiological assessment of the'role ofphysical activity and fitness in development of cardiovascular disease.Am. Heart J. 1985; 109:867-885.
3. Blair SN, Cooper KH, ribbons LW, Gettman LR, Lewis S, Goodyear N: Changes
in coronary heart dis .ase risk factors associated with increasedU treadmill time in 753 men. Am. J. Epidemiology 1983; 118:352-359.
4. Mitchell JH, Sproule BJ, Chapman CB: The physiological meaning of themaximal oxygen intake test. J. Clin. Invest 1958; 37:538-547.
5. Astrand PO, Rodahl K: Textbook of Work Physiology. New York, 1977,McGraw-Hill P.331.
6. Bruce RA, Kusumi F, Hosmer D: Maximal oxygen uptake and nomographicassessment of functional aerobic impairment in cardiovascular disease.Am Heart J. 1973; 85:5416-551.
7. Froelicher VF, Thompson AJ, Noguera I, Davis G, Stewart A, TriebwasserJH: Prediction of maximal oxygen consumption: Comparison of the Bruceand Balke treadmill protocols. Chest 1975; 68:331-336.
8. Cooper KH, Pollock ML, Martin RP, White SR, Linnerud AC, Jackson A:Physical fitness levels vs selected coronary risk factors. A cross-
sectional study. J. Am Med Assoc 1976; 236:166-169.
9. Gibbons LW, Blair SN, Cooper KH, Smith M: Association between coronaryheart disease risk factors and physical fitness in healthy adult women.Circulation 1983; 67:977-983.
10. Brown TE, Myles WS, Allen CL: The relationship between aerobic fitnessand certain cardiovascular risk factors. Aviat. Space Environ Med 1983;54:543-547.
11. Kannel WB, Dawber TR, Kagan A, Revotskie N, Stokes J: Factors of risk indevelopment of coronary heart disease - six year followup experience.The Framingham Study. Ann Intern Med 1961; 55:33-50.
12. Kannel WB, McGee D, Gordon T: A general cardiovascular risk profile:The Framingham Study. Am J. Cardiol 1976; 38:46-51.
13. Wolthius RA, Froelicher VF, Rischer J, Noguera I, Davis G, Stewart AJ,Triebwasser JH: New practical treadmill protocols for clinical use. AmJ Cardiol 1977; 39: 697-700.
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Aerobic Capacity and Coronary Risk Factors 14
14. Exercise Testing and Training of Apparently Healthy Individuals: AHandbook for Physicians. American Heart Association, 1972.
15. Taylor HL, Wang Y, Rowell L, Blomquist G: The standardization andinterpretation of submaximal and maximal tests of working capacity.Pediatrics (Suppl) 1963; 32:703.
16. Durnin, JVGA, Womersley JW: Body fat assessed from total body densityand its estimation from skinfold thickness: measurements on 481 men andwomen aged from 16 to 72. Brit. J. Nutr. 1974; 32:77-92.
17. Cumming GR, Borysyk LM: Criteria for maximum oxygen uptake in men over 40in a population survey. Med Sel Sports 1972; 4:18-22.
18. Wilmore J, Royce J, Girandola R, Katch F, Katch V: Physiologicalalterations resulting from a 10 week program of jogging. Med Sci Sports1970; 2:7-14.
19. Saltin B, Hartley L, Kilbom A, Astrand A: Physical training in sedentarymiddle-aged and older men. II. Scand J. Clin Lab Invest 1969; 24:323-324.
20. Hanson J, Tabakian B, Levy A, Nedde W: Long-term physical training andcardiovascular dynamics in middle-aged men. Circulation 1968; 38:783-799.
21. Froelicher VF, Allen M, Lancaster MC: Maximal treadmill testing ofnormal USAF aircrewman. Aerospace Med 1974; 45:310-313.
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23. Shepard RJ: World standards of cardiorespiratory performances. Arch.Environ. Health 1966; 13:664-67224
24. Zoltick JM, McAllister HA, Bedynek JL: The United States Army cardio-vascular screening program. J. Cardiac Rehabit 1984; 4:530-535
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26. Denniston JC, Jackson RE, Morgan WP, Ramos MU, Szurek JL, Vogel JA: Asurvey of cardiopulmonary health and coronary risk factors In a selectmilitary population. Milit. Med.1977; 141: 440-444.
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Aerobic Capacity and Coronary Risk Factors 15
28. Ingermann-Hansen T, Halkjaer-Kristensen J: Cigarette smoking and maximaloxygen consumption rate in humans. Scand. J. Clin. Lab. Invest. 1977;37: 143-148
29. Hirsch GL, Sue DY, Wasserman K, Robinson TE, Hansen ,TE: Immediateeffects of cigarette smoking on cardiorespiratory responses to exercise.J. Appl. Physiol. 1985; 58: 1975-1981.
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31. Marten AR, Holmik EV: The effects of cigarett* smoking on maximal oxygenconsumption and selected Physiological responses of elite team sportsmen.Eur. J. Appl. Physiol. 1985; 53: 348-352.
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Aerobic Capacity and Coronary Risk Factors 16
Table 1. Descriptive characteristics of subjects
Mean ± SD Range
Physical Characteristics (n = 295)
Age, yrs 43.8 ± 3.0 40 - 53.
Height, cm 178.8 ± 6.7 155 - 196
Weight, kg 83.5 ± 11.4 r,.6 - 115.7
%Body Fat 26.0 ± 4.6 .6 - 36.5
Exercise Capacity (n = 261)
Peak HR, BPM 182 ± 9 157 - 203
Peak VE t/min 123.1 ± 23.8 60.8 - 189.5
Peak V02, £/min 3.16± 0.5 1.71- 4.58
Peak VO2, ml/kg-min 38.1 ± 6.2 25.3 - 61.1
TM time, min 15.3 ± 2.9 6 - 24
Blood Pressure (n - 295)
Systolic, mmHg 124 ± 14 100 - 194.4x.
Diastolic, mmHg 81 ± 9 55 - 120
Blood Constituents (n = 295)
: Cholesterol, mg/dl 215 ± 38 95 - 354
HDL-C,mg/dl 41.2 ± 11.5. 14 - 99
Cholesterol/HDL-C 5.5 ± 1.7 1.0 - 9.9
Triglycerides, mg/dl 159 ±112 35 - 399
Fasting Blood Sugar, mg/dl 98 ± 20 30 - 158
Risk Factor Index, % 3.4 ± 2.2 0.7 - 16.9
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Aerobic Capacity and Coronary Risk Factors 17
Table 2. Prevalence of coronary risk factors
Risk Factor Prevalence (percent)
Percent Body Fat >25 < 30 46.4>30 17.4
Peak 02 > 30 < 35 ml/kg-min 23.5< 30 F /kg-min 8.5
Blood Pressure > 140/90 < 160/95 17.87 160/95 6.1
Cholesterol > 200 < 250 mg/dl 44.0> 250 mg/dl 17.8
Cholesterol/HDL-C > 6.0 33.1
Fasting Blood Sugar > 115 mg/dl 6.5
Triglycerides > 150 mg/dl 41.3
ECG Abnormal2ties, at rest 16.7at exercise 8.8
Cigarette Smoking 50.3
* Positive Cardiovascular 5.0History
Positive Cardiovascular 11.0Physical
Risk Factor Index > 5% 18.0
a. ._- -- ~
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Aerobic Capacity and Coronary Risk Factors 18
Table 3. Levels of aerobic capacity and selected anthropometric andphysiologic variables (mean + SD).
Aerobic Capacity, ml/kg-min
145
n 23 61 86 59 32
Age, yrs 44.5 43.9 44.1 43.8 42.83.6 2.7 2.9 3.14 2.1
Height, cm 180.6 179.5 178.0 179.2 178.145.8 6.3 6.3 7.5 7.14
Weight, kg 92.5** 85.6* 83.14 82.0 76.013.7 11.3 10.5 9.2 8.2
% Body Fat 31.0** 26.8* 26.1* 214.8 22.94.14 4.2 4.2 4.14 3.9
Peak HR,BPM 179 181 182 183 18111 10 9 10 7
Peak V EPI/min 103.7** 112.8** 122-3* 133.0 139.814.1 19.1 21.7 21.7 27.5
Peak RER 1.18 1.18 1.17 1.16 1.150.12 0.08 0.08 0.08 0.08
TM time, min 12.5** 13.14** 15.6** 17.0* 18.92.1 1.6 1.8 2.3 1.9
*p
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Aerobic Capacity and Coronary Risk Factors 19
Table 4. Levels of aerobic capacity and coronary risk factors (mean + SD)
Aerobic Capacity, ml/kg-min
145
n 23 61 86 59 32
Smokers, % 77** 72** 48* 29 22
SBP, mmHg 129* 1214 125 122 119
21 15 13 12 11
DBP, mmHg 86' 82 81 80 7712 8 8 9 7
TC, mg/dl 222 2214 217 205 203141 39 35 38 37
HDL-C,mg/dl 38.1* 37.7* 41.8 42.6 48.110.9 7.6 10.14 13.14 114.3
TC/HDL-C 6.1* 6.1* 5.14 5.1 4.61.8 1.5 1.5 1.6 1.6
Trig, mi/di 189 172 171 137 122109 115 138 76 66
FBS, mg/dl 110* 98 96 914 93314 10 11 10 8
RF Index, % 4.7** 4.0 3.14 2.6 2.53.5 2.5 2.1 1.8 1.6
*p
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